Patient Forms + Documents 

This is paragraph text. Click it or hit the Manage Text button to change the font, color, size, format, and more. To set up site-wide paragraph and title styles, go to Site Theme.

You have a Part to Play As Well

Your responsibilities to ensure your health include:
  • Asking questions and being active in your care.
  • Providing your health history, and other important information, including any changes in your health.
  • Informing us whenever there is a problem with a medication you are taking.
  • Calling our office first with your health concerns unless it is an emergency.
  • Informing us whenever you utilize any other health system such as the emergency room or a self-referral to a specialist.
  • Having a clear understanding about your treatment goals and future health goals.

Accessible Patient Forms



Are You Prepping For Your

 First Visit?

Patient Forms To Complete For Your First Visit


If you have scheduled a first time appointment as a new patient, we kindly ask that you complete our New Patient Registration forms to make sure that you understand your rights and responsibilities. It is very important that you read each document below and print them out prior to your visit. This will help to decrease your wait time and increase the time spent with your provider. 

Privacy Consent

Form

English

Spanish

Haitian/Creole


Patient Demographic Form

English

Statement Of Financial Responsibility

English

Spanish

Haitian/Creole

Consent For Medical Treatment

English

Spanish

Haitian/Creole

We can help you find a doctor. Call 718-596-9800 or browse our specialists.